Active NPI
Erick Jon Seidl Jr., B.S., PTA
- Physical Therapy Assistant
- Sturgeon Bay, WI
National Provider Identifier
1609689116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4105-19
- Practice address
- 200 N 7TH Ave
Sturgeon Bay, WI 54235-1708 - Phone
- (192) 074-3627
- NPI assigned
- Jan 29, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4105-19 | WI | Primary |
Addresses
Primary practice location
200 N 7TH Ave
Sturgeon Bay, WI 54235-1708
Mailing address
235 Lynch Ave
Denmark, WI 54208-9189
Phone (920) 784-1688
Other practice location 1
1610 Hoover St
New Holstein, WI 53061-1636
Phone (192) 089-8570
Other practice location 2
1 Hamilton Dr
Two Rivers, WI 54241-2335
Phone (192) 079-3226
Other practice location 3
1712 Monroe St
New Holstein, WI 53061-1307
Phone (192) 089-8429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4105-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1609689116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 LYNCH AVE",
"city": "DENMARK",
"state": "WI",
"postal_code": "542089189",
"telephone_number": "920-784-1688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N 7TH AVE",
"city": "STURGEON BAY",
"state": "WI",
"postal_code": "542351708",
"telephone_number": "192-074-3627"
}
],
"practiceLocations": [
{
"address_1": "1610 Hoover St",
"address_purpose": "LOCATION",
"city": "New Holstein",
"state": "WI",
"postal_code": "530611636",
"country_code": "US",
"telephone_number": "192-089-8570",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Hamilton Dr",
"address_purpose": "LOCATION",
"city": "Two Rivers",
"state": "WI",
"postal_code": "542412335",
"country_code": "US",
"telephone_number": "192-079-3226",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1712 Monroe St",
"address_purpose": "LOCATION",
"city": "New Holstein",
"state": "WI",
"postal_code": "530611307",
"country_code": "US",
"telephone_number": "192-089-8429",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEIDL",
"first_name": "ERICK",
"middle_name": "JON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "B.S., PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "4105-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sturgeon Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.